MEDICARE: KORVER EYE CARE

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	261QH0100X	Health Service Clinic/Center	2181	IA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1821369950
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	KORVER EYE CARE

Provider Business Mailing Address
First Line	:	3535 SOUTHERN HILLS DR
Second Line	:
City	:	SIOUX CITY
State	:	IA
Zip	:	51106-4749
Country	:	US
Telephone Number	:	712-276-2323
Fax Number	:	712-274-9986

Provider Business Practice Location Address
First Line	:	3535 SOUTHERN HILLS DR
Second Line	:
City	:	SIOUX CITY
State	:	IA
Zip	:	51106-4749
Country	:	US
Telephone Number	:	712-276-2323
Fax Number	:	712-274-9986

Authorized Official
Title or Position	:	OWNER
Name	:	JOHN KORVER
Credential	:
Telephone Number	:	712-276-2323

Provider Enumeration Date	:	01/20/2012
Last Update Date	:	01/20/2012

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Directions to “KORVER EYE CARE ” Practice Location

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